VH12 ESD of a Large Colonic Submucosal Lipoma Causing Recurrent Intussusception

hospital. We repeated colonoscopy and found that the cancer could not be lifted with submucosal injection, so it was impossible to resect the lesion with EMR or ESD. The patient was not a surgical candidate due to severe concomitant illnesses. In this situation we decided to perform full-thickness endoscopic resection to prevent further bleeding. Endoscopic Methods: The entire tumor was resected within healthy tissues in a piece-meal fashion creating full-thickness defect in colonic wall 4x6 cm in size. Using Overstitch endoscopic suturing device (Apollo Endosurgery, Inc, Austin, TX, USA, the defect in colonic wall was closed with continuous suture line made of 2 stitches. The patient was discharged home in a stable condition on the 3 day post colonoscopy. Followup endoscopies in 3 and 6 months demonstrated excellent healing of the site of resection without any strictures or residual cancer tissue left. Clinical Implications: This is the first purely endoscopic full-thickness resection of colon cancer in the world. The procedure was technically easy and straight-forward and patient tolerated this procedure without any problems or complications. Follow up in 3 and 6 months demonstrated excellent healing of the colonic wall without any strictures or residual malignancy.